Pain is so pervasive and so enmeshed with our daily experience that we can forget what life was like without it. We may lose a sense of who we were before pain entered the picture.

When I began to return from the most intense part of my own journey with pain, I realized that I was going to have to find a way to disentangle myself from it, to disengage my sense of who I was, my identity, from pain.

Pain Changes You

At the time, I couldn’t find a sensation of body-without-pain, even in my imagination, and I couldn’t envision a future without pain, though I desperately desired it. I had forgotten who I was without pain, and I wasn’t sure who I had become from the experience.

I certainly knew I had changed irrevocably, but I wasn’t quite sure in which direction all the changes lay.

Pain had become so embedded in my body, my daily routines, and my awareness, that this constant companion had become too familiar, like a terrorist and his hostage. Perhaps this is a familiar feeling for you.

The difficulty doesn’t lie in wanting to keep pain around like an old pal, far from it. It lies in the fact that pain has been with us for so long that we aren’t sure what will be left of us when it finally departs.

Will it take most of us with it? What does it mean about who we are if pain never leaves? Maybe we’re not even sure we have an identity beyond the pain anymore.

Rediscovering The Self After Pain

This merging of the sense of self-identity with the self-in-pain is really important to recognize.

I found that, in order to find myself again and to re-engage with the inner me (as opposed to seeing myself only as the-one-in-pain), I had to disengage my self-image and feelings of self-worth from my experience of pain and my body’s limitations.

I worried that my injury, my pain, and my being in need of assistance had turned me into a weak and needy person. I had to realize that just because my body felt weak, didn’t mean I was weak as a person. Just because my body was in pain, didn’t mean I was being a pain. Because my pain created new needs which I had to learn to communicate, didn’t mean I had turned into a needy person.

Many of us who have been in pain for a long time have been living in reaction to pain. We have allowed pain to become the organizing principle in our lives. s the only real power in life. We might shift all our choice making onto pain’s shoulders. After all, it seems to rule everything.

This seems like the only choice there is, but there is a subtle but important shift that seems to be necessary during the healing process, and that is to move the responsibility, power, and decision-making back onto our own shoulders. This is part of dis-identifying with pain and disentangling ourselves from it.

While pain is certainly the reason we can’t do many things, we need to be careful not to allow ourselves to think that it is the director of our lives. We can make the small but vital shift in our perception of who we are in pain, as we begin to find a way out of living utterly beholden to pain and connected to it on an identity level.

Dis-Identifying With Pain

As far as I can tell, this process has the potential of gradually unfolding something like these five steps:

1. Pain Arrives: We resist, we do all the “right” things, including therapies and medications. Pain doesn’t leave, so we try harder to get rid of it, adding alternative therapies, prayer, more willpower, more and different medications, etc.

2. Pain Stays: It still won’t leave. It may even get worse. The longer we live with pain, the more difficult it becomes to see ourselves beyond or through it.

3. We Learn to Work with Pain: We come to a place of honoring pain’s presence and its unusual gifts. We stop fighting against pain and begin to work with it and through it, regaining a sense of self that is not utterly beholden to pain as dictator and director. We recognize pain as something that is trying to heal itself in and through us.

4. We Realize Pain is One Aspect of our Lives, Not the Totality: Pain represents a very demanding part of our experience, but it is not who we are. It is a landscape we are walking through. Our inner selves are still intact. We learn to work with pain differently, seeing both it and ourselves from a different perspective.

5. Pain Begins to Relax, reduce, and dissolve.

Ultimately, whether pain completely leaves, or it stays for some time longer, we can let go of identifying with the pain as us, and ask ourselves who we want to become from and through the incredibly challenging experience of living with pain.

When we reconnect with our inner selves beyond the pain, we can find renewal. We can accept all of our experience with pain as part of a greater path, putting ourselves at the center (rather than pain), and live with more ease, grace, well-being, and inner peace.

During the first six years of living with pain, I slept in short catnaps only, and never fell into a deep, restful sleep. During the day, I was a total zombie, stumbling around in a state of severe sleep deprivation.

Does this sound familiar?

Why can’t we sleep? Certain drugs cause insomnia, the discomfort of pain certainly keeps us awake, and worry and stress keep our minds whirling around in circles. These are pretty obvious causes of insomnia.

But I feel there are a couple of others as well: while in pain, our body is continually on high alert, and we also have excess physical and mental energy we haven’t expended during the day.

Medications

I was given medication for nerve pain that was supposed to make me feel better. The list of possible side effects unfolded like one of those Jacob’s Ladder toys. The paper was several feet long in tiny print. I stopped reading after sudden death.

I became foggier than usual, had terrible headaches, felt nauseated all the time, and, you guessed it, had worse insomnia than ever.

I’m not even sure insomnia was on that scroll of possible side effects, and it wasn’t something my doctor had warned me could happen. Who knew? Anyway, my point is that your medications, yes, the ones that are supposed to be helping you feel less pain so you can get some sleep, may be keeping you awake.

If you think it’s even a remote possibility, talk to your doctor about lowering your dosage, or obtaining a different prescription. You may have to experiment for while and, of course, do this only under your doctor’s supervision.

Pain

What can be said about pain? It’s going to keep us awake at times, or maybe most of the time. Use pain medications (the ones that actually help you sleep!) judiciously to get some rest when you need to, of course.

I found that herbal teas were both natural relaxants and have pain reduction attributes as well and worked better for me than medications. The best of these, for me, was chamomile. Also, believe it or not, my mother’s old cure-all of warm milk and honey helped.

Maybe part of the efficacy of these home-brewed remedies is that they are soothing and warm and have associations with childhood memories of being taken care of by a loving hand.

How much comes from the ingredients and how much comes by association really doesn’t matter to me if they do the trick. Maybe you had a bedtime ritual when you were a kid that might help now. Who is going to fault a placebo if it helps you feel better?

Worry

Many nights I lay awake, staring into the darkness, my heart pounding, and my brain churning with very real fears about how I would survive financially with a body that was literally unemployable at any level.

Anxiety, besides keeping me awake, made my pain levels soar, so I had to learn to quiet my raging terrors and to turn down the volume on my brain’s churning and whirling through sheer force of will.

It takes a lot of courage and fortitude to do this, but we really can’t afford to raise stress levels through nighttime worries. It’s important to learn to soothe nerves and quiet frantic brain activities in order to sleep. I created a downloadable Fear Protocol which you may find useful.

High Alert

The body perceives a danger to its survival when we’re in pain from illness or injury. When the pain is short-term, the body resets itself naturally, and we come off high alert.

When we’re dealing with chronic pain, the body never really relaxes. It perceives an ongoing threat to its well being and remains tense and ready for battle, so we need to do something to mitigate this strain on the system.

I learned to consciously put my attention on noticing that there were no immediate dangers offering new threats to my survival. Whatever had happened to hurt my body had already happened, so I didn’t need my body to be so watchful.

I talked to my body calmly and told it that the immediate danger had passed. I consciously and deliberately noticed (again and again) that I had, indeed, survived another day.

Unused Physical Energy

Lying awake at night, I noticed a restlessness in my legs that was not exactly due to pain - they were just very, very uncomfortable. I realized that it reminded me of when I was a teenager. If I hadn’t exercised enough during the day, my legs would hurt at night from the unused physical energy.

I realized that because I couldn't really exercise with my condition, I had excess nervous energy and it was keeping me awake and adding to my discomfort. The only physical exercise I could get was walking, so I took extra short walks and that helped tremendously. The difference between not walking and walking 20 minutes was radical. Adding an extra walk not only helped with insomnia, it helped me sleep more deeply.

If you are not very mobile, try doing chair yoga, or even small, repetitive movements with your arms and legs. Whatever isn’t in pain - if it can be moved - move it. It also helps keep the lymph flowing through your body.

For those of you who can move only very minimally, it has been shown that the imagination can fool the body into thinking something is real. Use your creative imagination to do the things you can’t presently do physically. Take yourself for a hike, or go skiing, or ice skating, or swimming in your mind. Feel your body moving through the water, or walking on a dirt path in the woods, or gliding over the snow. Let yourself really go with it. Amazingly, it can help the body relax and release some of its pent up energy.

I hope some of these suggestions will be of use to you. You certainly may have others to add to the list, so feel free to share them in the comments section.

One of the reasons we may not be healing from chronic pain, is that we are expecting the ongoing pain we are experiencing now to act like the pains we have suffered in the past.

We expect all pain to become noticeably less painful as time passes, and, eventually to lose its sting. That’s what happens when you stub your toe. That’s what happens when you burn your hand. That’s even what happens when you grieve a loss.

It Won't Ride Off Into The Sunset

The other pains in life may be small, they may be huge, they may be overwhelming, but they all have a time frame. They arrive, we experience them in their smallness or bigness, and they quickly or slowly fade away. But they do fade away.

If not completely, then enough that we can move on with life and at some point in the future we realize that we don’t hurt any more in that way. The pain fades into the distance, as if it is linked to time as it recedes into the past.

The problem with the way we are thinking about and treating chronic pain is simply that it isn’t the same kind of pain. We tend to treat chronic pain with treatments created for short-term pain, but, for the most part, it refuses to budge.

Of course, chronic pain shows up initially as like all other physical pain. So, naturally, we begin with treating it like any other pain. But there comes a point when we have to recognize that we're dealing with a different beast.

We Need To Take A Different Road

This is when we have to reevaluate our strategy. After one or two or three months of persistent pain, we come to understand that the nature of the pain we are dealing with is simply not the same as short-term pain.

But, despite this re-labeling of our pain to chronic pain, most of the time we don’t change our strategy. We keep going further along the same road of treating all pain the same way. We think that if we do more of the same things, or do them longer, then we're addressing chronic pain.

After a point, however, it becomes clear that there just doesn’t seem to be any obvious healing for us down that road.

In addition, chronic pain comes with other physical ailments that don’t always fall under the category of “pain”, yet are, nevertheless, part of our experience of long-term pain. These include intense fatigue, inability to think clearly, constant flu-like symptoms, and an overall feeling of fogginess and depression, among others.

We begin to tell practitioners about the pain we’re in and they usually stop us once we’ve described what falls into the normal “pain” category. They don’t always want to know about the rest, either because they don’t consider that part of the “pain package” or because they simply don’t know what to do about them, so we are often left feeling misunderstood and unheard.

Understanding That Not All Pain Is The Same

For all these reasons, I feel it is important that we begin to think of chronic pain not just as pain that sticks around, but as a different kind of pain altogether. It is a unique condition, in a different category, and requiring unique approaches.

Too often, when medical practitioners feel stymied by chronic pain, they tend to blame the sufferer or disbelieve their reports of continued pain. Instead of blaming the patient, however, this should signal that our treatments, approaches, protocols and attitudes toward chronic pain need to be revamped, updated, and enlightened.

Since chronic pain eludes the efforts of our doctors to end it, we must understand that it therefore requires long-term treatment using a multi-layered approach, perhaps with many different practitioners.

We need to consider modalities, treatments, and approaches that do not just begin where short-term treatments leave off, but which look at, handle, and relate to pain in completely different ways right from the moment we realize our pain is chronic- ways that include the effects of chronic pain not only on the physical body, but on the emotions, psyche, and identity of the sufferer.

We need to understand that chronic pain is intrinsically a unique condition from short-term pain. It is dissimilar in the way it is generated, felt, experienced over time, and healed.

Disclaimer

Nothing on this website constitutes medical advice and is not intended to be a substitute for the medical advice of physicians. The reader should consult a physician in matters relating to his or her health and particularly with respect to any symptoms that may require diagnosis or medical attention.